The Role of Acupressure in Managing Chronic Pain: Mechanisms, Clinical Applications and Emerging Evidence

Abstract

Chronic pain is a complex biopsychosocial condition that can persist beyond normal tissue healing and substantially affect physical functioning, emotional well-being, sleep, work capacity, and quality of life. Limitations and adverse effects associated with long-term pharmacological treatment have contributed to increasing interest in non-pharmacological and complementary approaches. Acupressure, a non-invasive technique involving manual stimulation of specific body points, has emerged as a potentially useful adjunctive intervention for pain management. This review examines the role of acupressure in chronic pain, focusing on proposed mechanisms of action, clinical applications, effectiveness, safety, limitations of current evidence, and emerging research directions. Contemporary hypotheses suggest that acupressure may influence pain through peripheral sensory stimulation, spinal and supraspinal modulation of nociceptive processing, endogenous analgesic pathways, autonomic regulation, and psychological mechanisms involving relaxation and reduced stress. Clinical investigations have explored its application in musculoskeletal pain, osteoarthritis, low-back pain, neck and shoulder pain, cancer-related pain, fibromyalgia, and other persistent pain conditions. Although some studies report reductions in pain intensity and improvements in functional or psychological outcomes, the evidence remains heterogeneous because of differences in acupoints, pressure techniques, treatment frequency, intervention duration, control conditions, and outcome measures. The distinction between point-specific effects and nonspecific effects associated with touch, attention, expectation, and relaxation also remains an important methodological issue. Acupressure generally appears to have a favorable safety profile when appropriately administered and may have particular value as part of multimodal pain management. However, it should not be considered a replacement for medical evaluation or evidence-based treatment of underlying disease. Future research should prioritize adequately powered randomized controlled trials, standardized intervention reporting, objective and patient-centered outcomes, mechanistic studies, longer follow-up, cost-effectiveness evaluation, and investigation of digital and wearable pressure-based technologies. A stronger evidence base could clarify the patient populations and clinical circumstances in which acupressure provides meaningful additional benefit.